More people in Somerset with ovarian cancer are surviving over 12 months from diagnosis than almost everywhere else in the country, according to a report published by NHS England.
The report shows that in the latest national audit, taken in 2021, 77% of those with ovarian cancer are surviving at least one year after their diagnosis, with only one NHS trust ranking higher.
Miss Jo Morrison, a gynaecological-oncology consultant at Somerset NHS Foundation Trust, said she’s honoured to be part of the Somerset team that aims to consistently provide high-quality care to patients with ovarian cancer.
“Ovarian cancer tends to present late when it cannot be kept away forever, even with the best treatment,” she said. “Our aim is therefore to cure where we can and to help everyone live longer and better.
“Sadly many people will not survive long-term with ovarian cancer, though even where treatment is unlikely to be curative, it can often give people several years of good quality life.
“To come second in the country for ovarian cancer survival rates is an incredible achievement. Our 12-month survival rates are similar to those in the best-performing countries internationally, such as Norway and Denmark.”
The National Ovarian Cancer Audit first came about following concerns that cancer survival rates in the UK weren’t as good as in other countries in Europe.
Originally this work was driven by clinicians and patient support groups, who wanted to improve outcomes through understanding of why there was so much variation across the country.
“Thanks to the support of the British Gynaecological Cancer Society and the ovarian cancer charities, we contributed to a national pilot audit, which demonstrated big differences between centres across the UK,” continued Miss Morrison.
“This national audit has now been adopted by the NHS, through the National Cancer Audit Collaborating Centre, so it will continue long-term.
“The first report was recently published on the centre’s website and takes data directly from our local systems, but we identified gaps due to issues with the data quality, as about half of the data were missing.
“That’s where our multi-disciplinary team coordinator, Jodie Woodland, our pathway coordinator, Tracey McEwan, and Maria Murrey, our lead cancer nurse specialist, have worked tirelessly to fill in the gaps, to give us a much more accurate understanding of our performance and survival rates.
“We thought, from the pilot audit, and a research study we were involved with, called IMPRESS, that we were doing well, but we weren’t able to demonstrate this officially until now.
“There is a push by some of the big centres to provide care for people with ovarian cancer only through centres that serve large populations, regardless of age and population density/travel times to access care.
“The national audit data shows that bigger isn’t always better. It will also help us to keep ovarian cancer surgery in Somerset for many years to come, enabling women to access care who may not be well enough to travel further and might otherwise miss out on treatment.”
Many patients tend to present to their GP or other clinician when their ovarian cancer is advanced, something that can sadly narrow treatment options and the chance of a positive outcome.
Miss Morrison added: “Research studies have shown that overall there’s no difference in survival if we either perform surgery or give chemotherapy first…but we know that some people will do better with one or the other.
“The key is to understand the individual patient, how ovarian cancer has affected them, and their wishes, to help choose the best treatment for them.
“Separately, we are contributing to a research project, led by a team in Manchester, to develop a tool to make a more objective assessment of which treatment might be best first.
“Through this we aim to make a patient decision aid, so patients can understand the advantages and disadvantages to them individually of having surgery or chemotherapy first.
“We hope to test this with patients in the near future, as part of a bigger national research study, that looks at the impact of improving shared decision-making with patients, if we can secure funding for the research.”
The survival results show that there’s an efficient system in Somerset, where potentially crucial delays are minimised, wherever possible.
“We triage each patient through telephone appointments initially and we see people once they’ve had scans,” Miss Morrison said.
“We are also hugely supported by the other services that get us to that point, such as our radiology colleagues.
“For example, if a patient has an unexpected ultrasound that looks really worrying, then our consultant radiologist, Dr John Hunter, or our lead sonographer, Caragh Mathew, have contacted us directly, or arranged a CT scan, because they know what the patient needs next.
“If the scan shows that the patient has a high volume of disease, and chemotherapy is likely to be the best first step, then Dr Hunter will often have already spoken to our interventional radiology team about a biopsy.…they’re so helpful with a real focus on doing the best for our patients.
“In Somerset we have a much older population than other areas of the country and we know that we have double the percentage of over-65 and over-80 year-olds, which is why the adjusted survival rate is important.
“Our results also show that our oncologists are proactive in treating people with chemotherapy, whereas the research we have been involved with previously shows that in other areas, fewer than half of those over 75 are considered fit enough for any treatment.
“I want to personally say a massive thank you to Jodie, Tracey and Maria for helping to make sure that our data is as accurate as it can be, as good quality data lets us demonstrate and celebrate all of the hard work done by the team to deliver high-quality care.
“Also, a massive thank you to everyone involved in that wider pathway and multidisciplinary team. Our results are due to the entire system working well, not just what surgery and chemotherapy we can offer.
“We can only achieve this because we have such great support – our radiology, pathology, oncology, anaesthetic, other surgical and theatre teams go above and beyond – so this represents a massive team effort.”